Background: Polypharmacy, i.e. taking five drugs or more, is both a public health and an economic issue. Medication reviews are structured interviews of the patient by the community pharmacist, aiming at optimizing the drug treatment and deprescribing useless, redundant or dangerous drugs. However, they remain difficult to perform and time-consuming. Several clinical decision support systems were developed for helping clinicians to manage polypharmacy. However, most were limited to the implementation of clinical practice guidelines. In this work, our objective is to design an innovative clinical decision support system for medication reviews and polypharmacy management, named ABiMed. Methods: ABiMed associates several approaches: guidelines implementation, but the automatic extraction of patient data from the GP's electronic health record and its transfer to the pharmacist, and the visual presentation of contextualized drug knowledge using visual analytics. We performed an ergonomic assessment and qualitative evaluations involving pharmacists and GPs during focus groups and workshops. Results: We describe the proposed architecture, which allows a collaborative multi-user usage. We present the various screens of ABiMed for entering or verifying patient data, for accessing drug knowledge (posology, adverse effects, interactions), for viewing STOPP/START rules and for suggesting modification to the treatment. Qualitative evaluations showed that health professionals were highly interested by our approach, associating the automatic guidelines execution with the visual presentation of drug knowledge. Conclusions: The association of guidelines implementation with visual presentation of knowledge is a promising approach for managing polypharmacy. Future works will focus on the improvement and the evaluation of ABiMed.

Structuring medical data in France remains a challenge mainly because of the lack of medical data due to privacy concerns and the lack of methods and approaches on processing the French language. One of these challenges is structuring drug-related information in French clinical documents. To our knowledge, over the last decade, there are less than five relevant papers that study French prescriptions. This paper proposes a new approach for extracting drug-related information from French clinical scanned documents while preserving patients' privacy. In addition, we deployed our method in a health data management platform where it is used to structure drug medical data and help patients organize their drug schedules. It can be implemented on any web or mobile platform. This work closes the gap between theoretical and practical work by creating an application adapted to real production problems. It is a combination of a rule-based phase and a Deep Learning approach. Finally, numerical results show the outperformance and relevance of the proposed methodology.